Aaron Belkin, Ph.D: Transgender medical costs are negligible for DoD
There’s a piece in the New England Journal of Medicine written by Aaron Belkin, Ph.D. entitled Caring for Our Transgender Troops — The Negligible Cost of Transition-Related Care to convince Defense Secretary Ashton Carter to lift the ban on transgender military personnel. Doctor Belkin, Ph.D says that the military can easily afford to allow transgender people to serve in the military. In fact, he figures that $.22/service member/month ought to cover it.
Of course, the cost will depend on how many transgender personnel serve and utilize care, and estimates are sensitive to certain assumptions, such as the expectation that the military will not become a “magnet” employer for transgender people seeking health care benefits. Though my utilization and cost estimates are quite close to actual data provided by an allied military force, it seems clear that under any plausible estimation method, the cost amounts to little more than a rounding error in the military’s $47.8 billion annual health care budget.
The $.22 is based on his estimate of 12,000 transgender folks currently serving. I’m not sure where he gets that figure from, and I’m pretty sure he doesn’t either;
My calculations are as follows. In 2014, scholars estimated that 15,500 transgender personnel served in the military out of a total force of 2,581,000, but they included troops who were ineligible for health benefits.1 Moreover, the military has become smaller in recent years: as of May 31, 2015, a total of 2,136,779 troops served in the Active and Selected Reserve components and were thus eligible for health benefits. Assuming that the number of transgender personnel has declined along with the overall force size, and excluding those serving in Reserve components whose members are ineligible for medical benefits, I estimate that 12,800 transgender troops serve currently and are eligible for health care.
Because nameless “scholars” actually “estimated” the number last year, well, that provides a good basis for the assumption, doesn’t it? But, even if that number is correct, that doesn’t mean that it will remain static, does it?
[S]cientists agree that for many, transition-related care (gender-affirming surgery, cross-sex hormone therapy, or both) is medically necessary, and state regulators have found medical exclusions to be indefensible and in some cases unlawfully discriminatory.
That cements the contention that the military will be a ““magnet” employer for transgender people seeking health care benefits” doesn’t it? Everyone who wants free re-assignment treatment will join. He then averages the cost of treatment for Californians who underwent the treatment at $29,929 for six years of treatment, and that in the Australian Army they only spent $22,132 per person.
There are costs, in other words, of not providing transition-related care, due to potential medical and psychological consequences of its denial, paired with the requirement to live a closeted life.
[…]
Some observers may object to the concept that the military should pay for transition-related care, but doctors agree that such care is medically necessary. And though costs can be high per treated person, they are low as a percentage of total health spending, similar to the cost of many other treatments that the military provides. Even if actual costs exceed these estimates on a per-capita basis for persons requiring care, the total cost of providing transition-related care will always have a negligible effect on the military health budget because of the small number treated and the cost savings that the provision of such care will yield.
Yeah, well, there are other things that Doctor Ph.D hasn’t considered. Like the fact that there are a lot of mental health issues involved – a lifetime of treatment and monitoring which will carry over to the VA and drain funds unnecessarily from that agency as well. I recommend that if a transgender member of the military requires more than the Doctor PhD’s $.22/month estimate that he pay it out of his pocket. You know, putting his money where his mouth is.
But the overarching question that needs to be answered by the Defense Secretary before he lifts the ban on transgender lifestyle in the military is; How does this improve the military? How does this improve our chances to win the next war? I mean that’s their whole reason for existing – to kill people and break things. So how does spending this $.22/day/month/servicemember make the service better. If the answer sounds like it is written by a social engineer, then the Secretary should decide against it.
Category: Big Pentagon
We can’t even properly fix the guys we break, now they are playing this game ???? Holy Crapola
+1000
+1000 again!
Another +1000 from me
Holy crap, indeed.
Dead on!
Classic example of false cost analysis technique #13: inappropriate cost allocation. The fact that the DoD has 2.2 million troops is completely irrelevant to the discussion. The vast majority of personnel in uniform are not transgendered, and therefore do not require transgender therapy. Including them in the average is therefore allocating a cost specific to a given activity across the entire organization. It’s no different than hiding the cost of an executive country club membership costing $1M per year in the total cost of employee benefits when only the company CEO and Senior VPs are allowed to use it. In other words: it’s bullsh!t, and transparently so. Anyone who thinks about it for 30 seconds can see that. It’s designed to do nothing – except to hide the actual cost of the policy by spreading it out over an unrelated population. What is relevant in this case is the average cost of the treatment, per year, of a transgendered member of the military. Using his own numbers, averaging the two possible costs yields somewhat over $4,338 per transgendered member of the military receiving treatment – or up to an additional $55+ million in extra medical costs DoD must pay annually, assuming the number of serving transgenders remains 12,800. The rate of 0.044 per 1000 seeking TG care and treatment is likewise inappropriate. While the surgery is a one-time cost, aftercare and special medications are required for life. And it’s also a benefit for which dependents will qualify. The number being treated will soon easily equal 12,800 or more. That cost will go up or down linearly with the number of transgendered military personnel and/or dependents – e.g., if the number of transgendered personnel and dependents doubles, that cost will double. That is true regardless of the total number of military personnel serving. Further: the cost is completely unnecessary, and will only detract from resources available for warfighting. This “fine doctor” is doing nothing more than hiding the magnitude of that unnecessary cost through misleading calculations based on irrelevant numbers in order to further a political agenda. Or, alternatively, he’s an… Read more »
Addendum: to put things into perspective, assuming an average pay/allowances/benefits cost of $50k per soldier (reasonable for a mix of E1-E5), that $55+M is likely enough money to fund paying salary and benefits costs for an additional 1,100 soldiers in a mix of grades between E1 and E5.
NO TRANSGENDERS!! period! They don’t have any balls…..and if they do, they are not theirs! 😉
I’ve read online that the average cost for the REQUIRED hormone meds is $200 AFTER civilian insurance pays their percentage. This is what the person pays out of pocket on average.
Not sure how they are arriving at this $22 number.
They’re assuming about 1.5% per year of transgenders serving will request treatment, then averaging that cost across every member of the military. That does come out to around $0.22 for each of the roughly 2.2 million Soldier/Sailor/Airman/Marines eligible for medical care – though the cost only benefits about 190 individuals.
That method is bullsh!t. First, it doesn’t account for retirees and dependents; they’ll be covered too, if not directly then by TRICARE. Second, the method doesn’t account for continuing aftercare; that’s a lifetime deal, and continues into retirement. Third, by using the total SSAM population they inappropriately allocate the cost across all military personnel. That’s BS, because it’s NOT a cost to all that can legitimately so allocated – it’s a relatively large cost that benefits only a handful. Spreading it across all hides that fact – and is IMO being done here intentionally for exactly that reason. Finally, it doesn’t account for unnecessary lost time or reduced productivity due to aftercare issues associated with the treatment.
What isn’t mentioned is complete loss of duty status so in essence, the individual is drawing pay and benefits for military service NOT being performed. You can’t enlist with a pre-existing condition until it’s fixed. Want to make yourself another gender? No problem. Do it BEFORE you join the military. Then just meet the physical requirements. Yeah. Good luck with that.
Even if the male who would be female, or female who would be male, got the surgery done pre-enlistment, they’re still not deployable, because of the hormone therapy.
Imagine a non-tran squad leader who has 12 post-op trans in his squad. He’s the only deployable one, because he’s not on hormones.
“But the overarching question that needs to be answered by the Defense Secretary before he lifts the ban on transgender lifestyle in the military is; How does this improve the military? How does this improve our chances to win the next war? I mean that’s their whole reason for existing – to kill people and break things. So how does spending this $.22/day/month/servicemember make the service better. If the answer sounds like it is written by a social engineer, then the Secretary should decide against it.”
Jonn – we all know he’s going to overturn the ban because of his “feelings”, not for the reasons that you mentioned above. It’s just another step in the PC/social experiment that we call the US military.
Ah Jonn,
Did you have to use a Navy photo to make you solid point?
Just askin’!
MCPO (single-gendered/male)
That’s Autumn Sandeen and we’ve been writing about him for years. He is the only transgender whose picture we have in a female uniform, well, aside from Kleyla and Robin Mitchell – who, by the way, are both Navy, too.
Gum Daggnit … Geeze Us … Whatever!
Master Chief, it must be those “simply dahling” uniforms that attract them.
Heh, heh…
it’s the Name tape on the Butt… Lol……
Because using Marines would be too easy, Master Chief.
“……What isn’t mentioned is complete loss of duty status so in essence, the individual is drawing pay and benefits for military service NOT being performed……”
Absolutely correct a soldier on quarters or light duty (recovering from surgery) makes you a person down. You get enough of that crap from normal duty injuries, pregnancies, or just dumb stuff soldiers are known for.
It will be interesting to see (yeah I think it’s a forgone conclusion it’s going to happen) how many look for the quickest exit out of the service just as soon as the surgery is healed up.
Saw that more than once with female Soldiers. A few months after enlisting, get knocked up, drop a kid, and take the chapter option to get out.
Sounds like a great use of taxpayer dollars, especially as the military suffers through sequestration or whatever it’s called.
River Rat RVN:Since this is clearly elective surgery, why not let the service member pay for it, and do not add the recovery time as good time (time served toward their ETS). Then see how many of these freaks take advantage of the system.
As has been pointed out before, these people are not actually TG’d until they’ve done all the stuff that goes with that. I am mystified by the idea that this ‘treatment’ is something that tax dollars should pay for. It is elective, not a requirement, no matter what the shrinks say. If they choose this route, TGs should be required to pay for it out of their own pockets, just as they do in the REAL world.
I’ve long since passed the ‘give-a-shit’ (GAS) point where this matters to me. I simply object to my tax money being used this way.
Actually, Ex-PH2 . . . some employer insurance plans now cover sex-reassignment therapy and surgery. I’ve read more than one account of that being the case; I believe they were all on the left coast, but I’m not positive. And I believe the VA also now provides transgender therapy – possibly including the surgery – in some cases.
Bottom line: it’s not always “on their own dime” anymore.
Regarding the VA, I had several discussions with DAV VSOs about non-service connected medical care.
If it is not connected to your military service, you have to pay for it yourself. If you have private insurance, they’ll take that. They still won’t take Medicare, though. So the VA will provide the service but the patient has to pay for anything NOT service-connected. It’s in the handbooks they’ve sent to me, including the most recent one.
Being TG is NOT a service-connected disorder. If these dysfunctional twits line up (hasn’t happened, has it?) for military service, thinking they can get the ‘treatment’ for free, that should be stopped. It should be at THEIR expense, not yours or mine.
And if these TGs are going to get an extra allowance for it, then what are the rest of the troops going to get?
If a veteran qualifies for VA medical care, when treated at a VA facility for non-service-connected conditions the veteran must pay the requisite copayments. Ditto, if the veteran receives a prescription from a VA provider.
However, if the vet is rated as having a 50+% disability; is a former POW; or is determined by the VA to be “catastrophically disabled” or is receiving “aid and assistance” payments, all copayments are waived and treatment is free. If they are rated at 10% to 40% disabled, all copayments other than prescription drugs for the treatment of non-service-connected conditions are waived. (In either case, if you have private health insurance they will bill that first; by law, like TRICARE the VA is second-payer to any private health insurance other than a qualified supplemental policy.)
Copayments may also be reduced by 80% if an individual has an income below established thresholds. Only vets in priority group 8 (no disability rating, not catastrophically disabled or receiving aid and assistance payments, no special group membership [ex-POW, radiation exposure, other defined special groups], income above threshold) get hit with the full copayments for everything.
http://www.va.gov/healthbenefits/cost/copays.asp
http://www.va.gov/healthbenefits/resources/publications/IB10-431_copay_requirements_at_a_glance.pdf
http://www.va.gov/HEALTHBENEFITS/resources/priority_groups.asp
Bottom line: it appears that under current policy the VA can fund most or all of a sex change if it is deemed “medically necessary”, provided the vet has a disability rating of 10% or greater or has a low income.
How long do you think it will be before that happens fairly commonly?
These people are mentally ill. A man telling you he is really a female has more problems than just having the wrong jiggly bits in his pants. In the past when someone thought they were Napoleon we didn’t give them one glove and a musket and point them toward Russia.
I could not trust serving under someone who was so F**ked in the head they could not tell what gender they are.
Valid point. As someone close to the mental health field, the number of individuals actually completing gender reassignment is relatively low. There is a huge psychological impact and the suicide rate is relatively high.
How soon before this becomes an issue in the VA system? Although, it actually is because you can now claim PTSD and file for compensation based on the military’s previous stand on gay and transgender issues.
Addendum – as Hondo mentioned the VA does cover therapy and in some cases, certain surgeries. However, it hasn’t been front and center or widely used -yet.
See this: http://valorguardians.com/blog/?p=61389&cpage=1#comment-2625340
The VA will DO the work, but if it is NOT service-connected, you have to pay for it yourself. Identifying as TG is NOT a result of military service.
See my comment above. If the vet has a VA disability rating of 10% or greater, it appears that most required copayments (e.g., copayments relating to inpatient and outpatient care) will be waived. And if the vet meets certain conditions, ALL copayments can be either reduced by 80% or waived entirely.
Hey maybe they can market these poor bastards as sort of a crazy killer outfit…scare those ISIS guys right of business…
You know what I mean? A unit of men so fucking crazy they’ll cut their own dicks off to get at the enemy….that kind of bat-shit crazy sons of bitches…sounds like a great summer blockbuster movie…
(Voice Over) In a world full of violent turmoil, terrorists run amok. Now there’s one force they never considered, one force that will be remembered for it’s ferocity, it’s willingness to sacrifice their manhood for vengeance willing to take an unimaginable step to get in the Army and get at the enemy…..Task Force 13 known as the “Inside Outers” men who willingly turn their penises into vaginas to fight the muslim enemy as women, knowing the muslim fear of being killed by female warriors…Don’t miss this blockbuster film…in all its transgendered gory glory…..
I’m certain Hollywood can’t wait to make that film…
Brain bleach!!!
I can see some of the film credits now.
Opening sequences were filmed at the Combined Services Training Facility in Trinidad, CO.
No gerbils were harmed in the process of making this film.
Battle Flags were provided by the Foo Foo Corp of San Francisco.
See, I like how you think.
We could start a production company and get this done my friend….
Set locations: Castro District, SF, CA; and Greenwich Village and Fire Island, NYC, NY.
Gaaaaadammit! You coulda warned us, VOV!
You are a sick and twisted individual.
I like that in a person.
Apparently “Joes wanting to become Janes” and vice versa are a higher priority to B. Hussein 0bama & Company than all the non-TG Veterans put together, this I’m sure they’ll become the next “protected class”. Holy Sheepshit, WTF X 1,000?!!!
Like I posted to USA today, how about we take that 5.6 million dollars and take care of the veterans this country continues to neglect.
Probably because as soon as the money became available, some liberal moonbat pol or bureaucrat would swipe it for more handouts to illegal aliens and welfare flunkies.
This is so true…
Maybe we should all buy a shit ton of Jack and ammunition and clean house
That would be nice. However, funds can be set aside for specific programs. Which are then raided for other purposes, of course. But you can bet if it’s earmarked for the “Special Cause du Jour” it will be unavailable to help anyone else.
“shaved his legs and then he was a she…”
No. That’s not how it works Dr. Belkin.
Take a Walk on the Wild Side: They still play that on the radio?
I heard that song has replaced “I Love You, California” as the official state anthem for FooFoo Land, so yeah, I think it’s still being played on the radio.
After much research at several truck stops, I’ve figured out that sucking another man’s unwashed cock has no intrinsic cost to me. I just suck around any open sores
What can I say? I’m a giver.
sincerely
John “Faker 6” Giduck
Yes Jumping From Sleeper To Sleeper Has Given Me.
A Serious Issue With Lock-Jaw, Go Figuere
So, dudes who think they’re ladies get the chop-shop and hormones before Veterans who sacrificed their health get the treatments they deserve? Is that it?
Time to sharpen the pitchforks and start boiling the oil.
Look at it this way:
In an effort to save money, the military can recycle those unwanted parts fairly easily. Chop off his, give it to her. Chop off hers, attach them to him….
It’s worth pointing out another hidden fallacy in this guy’s logic: medical costs are not the same in Australia as they are here. Australia, like many commonwealth nations, has socialized medicine, and the drug companies are limited in what they can/do charge for medications.
I recently received some medical care where, had my insurance not covered the medication, I had it recommended to me that I try buying it from the UK, Australia, or India, because while that would be expensive, it would be thousands of dollars cheaper than if I bought it without health insurance here in America.
So the ‘cost per transgender soldier’ that he cites, if it is based on Australian costs and not estimated at all based on American costs of medications and care, is not going to be even remotely accurate.
Yes indeed. What’s next, will the taxpayers get stuck with their cosmetic surgery expenses like facial surgery, breast implants,…?
Oh heck, the costs even WITHOUT surgery are pretty humongous. I recall reading that the average cost – hormone therapy alone is between $300 to $2400 a year on average (a pretty darn big average, that), while male-to-female surgery costs on average $17,000. Most places also have mandatory therapy prior to allowing hormones to be prescribed, let alone surgery – that adds on at least $1,000 per year.
Even if the military gets some kind of bulk deal on this (and I’m fairly sure that gender reassignment specialists are NOT currently one of the top surgical specialties currently recruited for military hospitals), we’re still looking at costs in excess of $10,000 per soldier (since it’s around $20,000 in the civilian medical expenses). And that’s not counting the cost of medical care going forward from reassignment.
Someone in a position to be listened to needs to go over this guy’s numbers, because even by the estimates of the experts who are in the field, his numbers are ‘interesting’, to say the least. I doublechecked my memory by looking at sites which focus on this subject and are pro-gender reassignment surgery etc. Since this is what they DO, I’m inclined to say they know the cost.
Look, the real problem here is that every fat kid is going to show up at the next APFT/weigh-in and say, “Whoa, wait a minute there–you’re using the wrong scale. I’m in the “F” column today.”